鼻内镜下上颌窦自然开口扩大术联合泪前隐窝入路切除术治疗非侵袭性真菌性鼻窦炎的疗效观察

doi:01.3969/j.issn.1006-6233.2020.12.014

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摘要 目的: 探究鼻内镜下上颌窦自然开口扩大术联合泪前隐窝入路切除术治疗非侵袭性真菌性鼻窦炎的疗效。方法: 将我院收治的148例非侵袭性真菌性鼻窦炎患者随机分组进行简单随机化分组为对照组和观察组各74例,对照组患者行鼻内镜下上颌窦自然开口扩大术治疗,观察组患者行鼻内镜下上颌窦自然开口扩大术联合泪前隐窝入路切除术治疗,比较两组患者临床疗效、手术情况、疼痛情况与鼻内镜评分及鼻窦CT评分、术后并发症与复发情况。结果: 观察组患者临床治疗总有效率高于对照组(P<0.05);观察组患者手术和术后住院的时间短于对照组(P<0.05),术中出血量少于对照组(P<0.05);术后6个月,两组患者视觉模拟评分法(VAS)疼痛评分、鼻内镜评分及鼻窦CT评分较术前均降低(P<0.05),且研究组上述指标手术前后评分差值均大于对照组(P<0.05);观察组患者术后并发症为5.41%(4/74),低于对照组的16.22%(12/74)(P<0.05),随访6个月,观察组和对照组患者复发率对应为2.70%(2/74)和8.11%(7/74),差异无统计学意义(P>0.05)。结论: 鼻内镜下上颌窦自然开口扩大术联合泪前隐窝入路切除术治疗非侵袭性真菌性鼻窦炎疗效显著,能够全面清理病灶,改善上颌窦术后的引流、降低术后并发症发生率,并有助于减少复发风险。

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	冯世斌
	赵存尧
	刘荣松

关键词 ：鼻内镜, 上颌窦自然开口扩大术, 泪前隐窝入路切除术, 非侵袭性真菌性鼻窦炎

Abstract：Objective: To explore the efficacy of nasal endoscopic maxillary sinus natural ostium enlargement combined with anterior lacrimal recess approach resection on non-invasive fungal rhino-sinusitis. Methods: 148 patients with non-invasive fungal rhino-sinusitis admitted to our hospital were randomly divided into control group and observation group by simple random grouping, with 74 cases in each group. Control group was given nasal endoscopic maxillary sinus natural ostium enlargement, and observation group was given nasal endoscopic maxillary sinus natural ostium enlargement combined with anterior lacrimal recess approach resection. The clinical efficacy, surgery, pain, nasal endoscopic examination score (Lund-Kennedy), postoperative complications and recurrence were compared between the two groups. Results: The total effective rate of clinical treatment in observation group was significantly higher than that in control group (P<0.05). The surgical time and postoperative hospital stay in observation group were significantly shorter than those in control group (P<0.05), and the intraoperative blood loss was significantly less than that in control group (P<0.05). At 6 months after surgery, the Visual Analogue Scale (VAS) pain score, nasal endoscopic score and nasal sinus CT score in the two groups were significantly lower than those before surgery (P<0.05), and the differences of the above scores before and after surgery in study group were greater than those in control group (P<0.05). The incidence rate of postoperative complications in observation group was lower than that in control group [5.41% (4/74) vs 16.22% (12/74)](P<0.05). At 6 months of follow-up, the recurrence rates in observation group and control group were 2.70% (2/74) and 8.11% (7/74) respectively (P>0.05). Conclusion: Nasal endoscopic maxillary sinus natural ostium enlargement combined with anterior lacrimal recess approach resection has a significant efficacy in the treatment of non-invasive fungal rhino-sinusitis. It can completely clear the lesions, improve drainage after maxillary sinus surgery, reduce the incidence rates of postoperative complications, and help reduce the risk of recurrence.

Key words： Nasal endoscopic Maxillary sinus natural ostium enlargement Anterior lacrimal recess approach resection Non-invasive fungal rhino-sinusitis

基金资助:重庆市黔江区科技计划基金项目,(编号:黔科计2019014)

引用本文:

冯世斌, 赵存尧, 刘荣松. 鼻内镜下上颌窦自然开口扩大术联合泪前隐窝入路切除术治疗非侵袭性真菌性鼻窦炎的疗效观察[J]. 河北医学, 2020, 26(12): 1995-1998.
FENG Shibin, ZHAO Cunyao, LIU Rongsong. Efficacy of Nasal Endoscopic Maxillary Sinus Natural Ostium Enlargement Combined with Anterior Lacrimal Recess Approach Resection in the Treatment of Non-Invasive Fungal Rhino-Sinusitis. HeBei Med, 2020, 26(12): 1995-1998.

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http://www.hbyxzzs.cn/CN/01.3969/j.issn.1006-6233.2020.12.014 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I12/1995